The signature legislation of President Barack Obama, the Patient Protection and Affordable Care Act, has caused uproar and celebration alike in the years since its inception. It has been portrayed as a partisan issue, causing conflict and eliciting emotional outcries from pundits and everyday citizens. This widely misunderstood Federal statute is the most significant regulatory overhaul of the U.S. healthcare system since the passage of Medicare and Medicaid in 1965.
Regardless of the measurable and objective improvement to the quality of healthcare coverage, as well as the dramatic increase of Americans with health insurance, the Republican controlled Congress is working to repeal the Affordable Care Act. With the entire American government, all three branches, being majority Republican, it’s hard to see how the law will stand.
In the shadow of its impending demise, this may be a final glimpse. So, while the pyre is built and the oil is poured on, let’s warm ourselves with those measurable improvements.
Increased Number of Insured Americans
No matter your stance on the positive or negative repercussions of the Affordable Care Act, the numbers show that the American people have been more widely insured since the passing of the law. This outcome was a direct result of the ease in accessibility of health insurance as well as the decrease in costs.
The number of people going it uninsured decreased by nearly half of the amount that it was at when the new law passed. The numbers reflect this: in 2010, around 16% of Americans were uninsured, and in the first quarter of 2016, only 8.9% were uninsured.
If those numbers aren’t enough to impress you, consider that a 7.1% increase is equivalent to 16.4 million people. But these are just the raw numbers of people who have been covered by the law — they say nothing about the success of the law’s battle against the quality of the coverage.
The Betterment of Health Coverage Quality
In the dark ages of healthcare, that is, the years before the renaissance of the ACA, being a woman was considered a pre-existing condition for which a person could actually be denied coverage. Not only does that kind of discrimination prevent large numbers of people being insured, it’s also disgraceful and embarrassing for a civilized nation.
Access to data has always been a priority of those utilizing it. Users are now craving access to data visualizations outside of the boardroom and office, and mobile data visualization is becoming the sought-after trend. The main challenge this imposes is representing the data in a way that is suitable for a small screen. Typical data visualizations are made with a large space in mind, but focusing on reducing graphs and charts to barebones and thinking about touchscreen capabilities can lead to more successful mobile implementations.
Now, because of the protection offered to everyone under the Affordable Care Act, insurance companies are banned from denying insurance coverage because of a person’s pre-existing medical conditions. People are also given the power to appeal an insurance company’s decision to deny doctor ordered treatments that are covered by insurance.
Due to the betterment of the quality of care, coupled with the protection offered to consumers through the ACA, the number of uninsured women increased by 7.7 million, and nearly 55 million women are also benefiting from preventive services coverage with no out-of-pocket costs.
Definition of Accountable Care Organizations
The Affordable Care Act built upon the definition of Accountable Care Organizations (ACO), which was introduced by Dr. Elliott Fisher, the Director of the Center for Health Policy Research at the Dartmouth Medical School. The law now explicitly allowed for the formation of such an organization.
An ACO is a group of doctors, hospitals, and other healthcare providers who voluntarily align to give coordinated high quality care to Medicare patients. The primary goal of the group is to ensure that the Medicare patients, with special attention given to the chronically ill, get adequate and timely care. They are also focused on preventing duplication or confusion of services in order to eliminate medical errors.
The organizations are monitored by regulatory organizations, and as such are subject to penalties and bonuses from the government. For example, if an ACO can minimize costs while achieving certain quality benchmarks, focused on the prevention and mitigation of chronic disease, they will receive bonus payments.
Medicaid Expansion Under the ACA
Because of the provisions of law at large, states were able to accept certain aspects of the Affordable Care Act but reject or modify others. One such example of this is the expansion of Medicaid under the ACA.
In 2016, a study of state Medicaid expansion was conducted by Benjamin Sommers, a Harvard health economics professor. The study concluded that residents of Kentucky and Arkansas were more likely to receive health care services and less likely to incur emergency room costs or have trouble paying their medical bills than before they expanded Medicaid. Texas, on the other hand, did not expand Medicaid, and their residents did not experience the same benefits.
The tale of Texas was told also in Florida, Alabama, Wyoming, Arizona, Oklahoma, and Missouri. In a show of non-cooperation, Missouri declined to both expand Medicaid and to establish and provide a health insurance marketplace. This effort was supported by certain Republican politicians launching public advertising campaigns in these states designed to discourage enrollment.
Sam Dickman, et. al., wrote in a 2014 study that “medicaid expansion” in Texas alone “would have resulted in 184,192 fewer depression diagnoses, 62,610 fewer individuals suffering catastrophic medical expenditures, and between 1,840 and 3,035 fewer deaths.” With just under 20 states opting out of expanding Medicaid, those numbers are sure to be much, much larger in reality.
Current Efforts to Repeal the ACA
The repulsion to the law expressed by the majority of Republicans has lead to work being done to not only oppose it, but to repeal it altogether. With control of Washington firmly in the hands of the Republicans after the 2016 elections, and with the veritable call to arms against the law issued by the president-elect, the Patient Protection and Affordable Care act might be living its last days. According to sources, the Republicans have set a deadline for repeal on January 27th, 2017.